CTICasesMultifocal Lung Adenocarcinoma
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Imaging findings
Serial imaging over a ten-year period. In 2004, CT demonstrates a pure ground-glass nodule along the right major fissure that was stable at five months and negative on PET. In 2014, the lesion has progressed to a solid nodule, and new pulmonary lesions have appeared, including a mixed ground-glass and solid lesion in the right middle lobe and a second solid lesion. Biopsies of two of these lesions confirmed multifocal lung adenocarcinoma.
Key takeaways
Pure ground-glass nodules represent a slow-growing spectrum of lung adenocarcinoma that can remain stable for many years before progressing to invasive, solid components. A negative PET scan cannot exclude malignancy in these low-metabolic lesions, and surveillance should be maintained long-term, often exceeding five to ten years. Multifocal lung adenocarcinomas are common, typically representing synchronous primary tumors with distinct genetic pathways rather than metastases.
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